Fermented Wheat Germ Extract
Also known by these names
- Brand names include Avemar, Avé, AvéULTRA, AWGE, Metatrol and OncoMAR
- FWGE
- MSC
- Wheat germ extract
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Key Points
- Before using this therapy, consult your oncology team about interactions with other treatments and therapies. Also make sure this therapy is safe for use with any other medical conditions you may have.
- Fermented wheat germ extract (FWGE) is a dietary supplement.
- BCCT interest in FWGE derives from its anticancer and anti-metastatic effects across several types of cancer.
- FWGE has enhanced the effectiveness of tamoxifen treatments in estrogen receptor-positive breast cancer cells.
- FWGE has reduced some chemotherapy-related side effects.
- Side effects and adverse events are uncommon and usually mild. Some patients should not use FWGE.
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 Author
Nancy Hepp, MS, BCCT Project Manager
Read more Ms. Hepp is a science researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. View profile.  Reviewer
Laura Pole, RN, MSN, OCNS, BCCT Senior Researcher
Read more Ms. Pole is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation and education services for more than 30 years. View profile. Last updated April 15, 2021.
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Fermented wheat germ extract (FWGE) is a dietary supplement sold as brand names including Avemar, Avé, AvéULTRA, AWGE, Metatrol and OncoMAR.
Treating the Cancer
Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action
Clinical Evidence
Colorectal Cancer
- Improved progression-free and overall survival in people with colorectal cancer treated with radical surgery plus radiotherapy and/or chemotherapy in small studies (both randomized and non-randomized)
- Reduced metastasis among patients treated with radical surgery plus radiotherapy and/or chemotherapy in a small non-randomized study
Melanoma
- Improved response to dacarbazine, extending both progression-free survival and overall survival, even in high-risk patients and advanced stages in melanoma in a small randomized trial
Oral Cancer
- Substantially reduced disease progression among people with oral cancer when added to radical surgery plus postoperative irradiation and/or adjuvant chemotherapy in small nonrandomized studies
Lab and Animal Evidence
Read more
- Reduced tumor size and metastasis with 5-fluorouracil (5-FU) or dacarbazine (DTIC) in mouse models
- Promoted cell death (apoptosis) of cancer cells while leaving normal cells unharmed, starved the sugar supply required by cancer cells to survive, unmasked cancer cells so they can be more readily targeted by the immune system and prevented abnormal cells from repairing themselves
- Breast cancer:
- Enhanced efficacy of tamoxifen in promoting cell death (apoptosis) and decreasing ER activity in ER+ breast cancer cells
- Enhanced estrogen-receptor (ER) activity when used alone
- Ovarian cancer:
- Induced cell death (apoptosis), slowed proliferation of human ovarian cancer cell lines
- Enhanced cytotoxicity of cisplatin and docetaxel in human ovarian cancer cell lines
Anticancer and anti-metastatic effects in cell studies with these further cancers:
Optimizing Your Terrain
Creating an environment within your body that does not support cancer development, growth or spread
Clinical Evidence
- Improved immune system markers in pediatric patients undergoing chemotherapy
Lab and Animal Evidence
Read more
- Altered immune response and enhanced immune activity, resulting in death of tumor cells, in animal studies
- Increased normal function of mitochondria, restoring normal metabolism and cell death processes, without any general or liver-specific toxic effects with A250 (a highly purified fraction of FWGE)
Managing Side Effects and Promoting Wellness
Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being
Clinical Evidence
In all, evidence to date is positive but not rigorous for improvements in side effects and quality of life:
Fatigue
- Improved fatigue among people with lung cancer receiving chemotherapy and/or radiotherapy in a small study
- Possibly improved or reduced side effects of conventional treatment including fatigue in limited clinical trials
Function and Quality of Life
- Improved quality of life
- Improved quality of life with lung cancer patients receiving chemotherapy and/or radiotherapy in a small study and with people with non-small cell lung cancer receiving chemotherapy
- Improved physical functions, emotional functions and global state of health among people with breast cancer in a small study
- Improved quality of life in head and neck cancer patients when added to conventional therapy
Nausea and Vomiting and Other Digestive Symptoms
Sleep Disruption
Other Symptoms
- Possibly improved or reduced side effects of conventional treatment, including hair loss and depleted immune system, in limited clinical trials
- Substantially improved wasting (cachectic) symptoms among people undergoing treatment for oral cancer in a small nonrandomized study
- Reduced chemotherapy-induced fever that accompanies an abnormally low number of neutrophils (a type of white blood cell) among pediatric cancer patients
- Fewer immune compromised/neutropenic episodes in pediatric patients undergoing chemotherapy
Reducing Risk
Reducing the risk of developing cancer or the risk of recurrence
Colorectal Cancer
Oral Cancer
- Substantially reduced local recurrences among people with oral cancer when added to radical surgery followed by irradiation and/or adjuvant chemotherapy in small nonrandomized studies
Cautions
FWGE is not recommended for use by pregnant and nursing women, patients with sensitivity to gluten, those with fructose intolerance, or patients with organ or tissue transplants.
Because FWGE may have estrogen-receptor activity, those with an estrogen-dependent cancer (some breast, ovarian or uterine cancers) should consult a licensed provider who is knowledgeable and experienced with using FWGE in such cancers.
Access
Fermented wheat germ extract supplements are widely available and generally low cost (<$500/year).
Dosing
BCCT does not recommend therapies or doses, but only provides information for patients and providers to consider as part of a complete treatment plan. Patients should discuss therapies with their physicians, as contraindications, interactions and side effects must be evaluated. Levels of active ingredients of natural products can vary widely between and even within products. See Quality and Sources of Herbs, Supplements and Other Natural Products.
Dosage recommendations are available from these sources:
Integrative Programs, Protocols and Medical Systems
- Programs and protocols
- Alschuler & Gazella complementary approaches:
- Block program
- Targeted therapy when other treatment isn't working
- Parmar & Kazcor treatment plans
Non-cancer Uses of FWGE
FWGE has been used in treatment for heart disease as well as systemic lupus erythematosus (SLE), an autoimmune disease. BCCT has not reviewed the effectiveness of this therapy for non-cancer uses.
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- Jakab F, Shoenfeld Y et al. A medical nutriment has supportive value in the treatment of colorectal cancer. British Journal of Cancer. 2003 Aug 4;89(3):465-9; Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
- Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
- Demidov LV, Manziuk LV, Kharkevitch GY, Pirogova NA, Artamonova EV. Adjuvant fermented wheat germ extract (Avemar) nutraceutical improves survival of high-risk skin melanoma patients: a randomized, pilot, phase II clinical study with a 7-year follow-up. Cancer Biotherapy & Radiopharmaceuticals. 2008 Aug;23(4):477-82.
- Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
- Mueller T, Voigt W. Fermented wheat germ extract—nutritional supplement or anticancer drug? Nutrition Journal. 2011 Sep 5;10:89; Mueller T, Jordan K, Voigt W. Promising cytotoxic activity profile of fermented wheat germ extract (Avemar®) in human cancer cell lines. Journal of Experimental & Clinical Cancer Research. 2011 Apr 16;30(1):42.
- Yeend T, Robinson K, Lockwood C, McArthur A. The effectiveness of fermented wheat germ extract as an adjunct therapy in the treatment of cancer: a systematic review. JBI Library of Systematic Reviews. 2012;10(42 Suppl):1-12.
- Marcsek Z, Kocsis Z, Jakab M, Szende B, Tompa A. The efficacy of tamoxifen in estrogen receptor-positive breast cancer cells is enhanced by a medical nutriment. Cancer Biother Radiopharm. 2004 Dec;19(6):746-53.
- Marcsek Z, Kocsis Z, Jakab M, Szende B, Tompa A. The efficacy of tamoxifen in estrogen receptor-positive breast cancer cells is enhanced by a medical nutriment. Cancer Biother Radiopharm. 2004 Dec;19(6):746-53.
- Judson PL, Al Sawah E et al. Characterizing the efficacy of fermented wheat germ extract against ovarian cancer and defining the genomic basis of its activity. International Journal of Gynecological Cancer. 2012 Jul;22(6):960-7; Wang CW, Wang CK et al. Preclinical evaluation on the tumor suppression efficiency and combination drug effects of fermented wheat germ extract in human ovarian carcinoma cells. Evidence-based Complementary and Alternative Medicine. 2015;2015:570785.
- Judson PL, Al Sawah E et al. Characterizing the efficacy of fermented wheat germ extract against ovarian cancer and defining the genomic basis of its activity. International Journal of Gynecological Cancer. 2012 Jul;22(6):960-7; Wang CW, Wang CK et al. Preclinical evaluation on the tumor suppression efficiency and combination drug effects of fermented wheat germ extract in human ovarian carcinoma cells. Evidence-based Complementary and Alternative Medicine. 2015;2015:570785.
- Zhurakivska K, Troiano G et al. The effects of adjuvant fermented wheat germ extract on cancer cell lines: a systematic review. Nutrients. 2018 Oct 19;10(10). pii: E1546.
- Radossi AL, Taromina K et al. A systematic review of integrative clinical trials for supportive care in pediatric oncology: a report from the International Society of Pediatric Oncology, T&CM collaborative. Supportive Care in Cancer. 2018 Feb;26(2):375-391.
- Mueller T, Voigt W. Fermented wheat germ extract—nutritional supplement or anticancer drug? Nutrition Journal. 2011 Sep 5;10:89.
- Mueller T, Voigt W. Fermented wheat germ extract—nutritional supplement or anticancer drug? Nutrition Journal. 2011 Sep 5;10:89; Telekes A, Hegedus M, Chae CH, Vékey K. Avemar (wheat germ extract) in cancer prevention and treatment. Nutrition and Cancer. 2009;61(6):891-9.
- Bencze G, Bencze S et al. Mito-oncology agent: fermented extract suppresses the Warburg effect, restores oxidative mitochondrial activity, and inhibits in vivo tumor growth. Scientific Reports. 2020 Aug 25;10(1):14174.
- Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
- Yeend T, Robinson K, Lockwood C, McArthur A. The effectiveness of fermented wheat germ extract as an adjunct therapy in the treatment of cancer: a systematic review. JBI Library of Systematic Reviews. 2012;10(42 Suppl):1-12.
- Mueller T, Voigt W. Fermented wheat germ extract—nutritional supplement or anticancer drug? Nutrition Journal. 2011 Sep 5;10:89; Yeend T, Robinson K, Lockwood C, McArthur A. The effectiveness of fermented wheat germ extract as an adjunct therapy in the treatment of cancer: a systematic review. JBI Library of Systematic Reviews. 2012;10(42 Suppl):1-12.
- Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
- Hidvegi M, Moldvay J, Lapis K. Fermented wheat germ extract improves quality of life in lung cancer patients. (In Hungarian.) (Medicus Anonymus/Pulmono 11: 13-14). 2003. As described at CAM-Cancer. Fermented wheat germ extract. February 8, 2017. Viewed January 1, 2017.
- Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
- Sukkar SG, Cella F et al. A multicentric prospective open trial on the quality of life and oxidative stress in patients affected by advanced head and neck cancer treated with a new benzoquinone-rich product derived from fermented wheat germ (Avemar). Mediterranean Journal of Nutrition and Metabolism. 2008;1:37–42.
- Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
- Yeend T, Robinson K, Lockwood C, McArthur A. The effectiveness of fermented wheat germ extract as an adjunct therapy in the treatment of cancer: a systematic review. JBI Library of Systematic Reviews. 2012;10(42 Suppl):1-12
- Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
- Yeend T, Robinson K, Lockwood C, McArthur A. The effectiveness of fermented wheat germ extract as an adjunct therapy in the treatment of cancer: a systematic review. JBI Library of Systematic Reviews. 2012;10(42 Suppl):1-12.
- Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
- Garami M, Schuler D et al. Fermented wheat germ extract reduces chemotherapy-induced febrile neutropenia in pediatric cancer patients. Journal of Pediatric Hematology/Oncology. 2004 Oct;26(10):631-5.
- Radossi AL, Taromina K et al. A systematic review of integrative clinical trials for supportive care in pediatric oncology: a report from the International Society of Pediatric Oncology, T&CM collaborative. Supportive Care in Cancer. 2018 Feb;26(2):375-391.
- Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
- Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
- Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010.
- Block KI. Life over Cancer: The Block Center Program for Integrative Cancer Treatment. New York: Bantam Dell. 2009.
- Parmar G, Kaczor T. Textbook of Naturopathic Oncology: A Desktop Guide of Integrative Cancer Care. 1st edition. Canada: Medicatrix Holdings Ltd. 2020.
View All References
More Information
- Memorial Sloan Kettering Cancer Center’s About Herbs: Wheat germ extract
- CAM-Cancer Summaries: Fermented wheat germ extract
- Moss Reports (purchase required): Select from the list of cancers down the left side of the page for a report describing uses of conventional, complementary, alternative and integrative therapies related to that cancer. Ralph Moss is among the most knowledgeable and balanced researchers of integrative cancer therapies. The cost of his Moss Reports is not negligible, but many patients find them of considerable value. Moss is also available for consultations.
- TRC Natural Medicines: Fermented Wheat Germ Extract (subscription required): in-depth information, ratings of effectiveness and safety and evaluation of specific FWGE products
- The Moss Report Podcast: Can Cancer Cells Become Normal Again?
- Lise Alschuler, ND, FABNO, and Karolyn Gazella: The Definitive Guide to Cancer, 3rd Edition
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